Appendix A

BridgeLink: Assuring Independence at home DRAFT

Telecare Strategy for Bridgend 2008 – 2011

Telecare Strategy
For Bridgend County Borough 2008 -
2011

1
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011

Contents
Section One: Introduction
• Vision for Telecare in Bridgend 3
• Purpose of the Strategy 3
• Telecare Capital and Revenue Grants 3
• Desired outcomes from the Grant Funding 3

Section Two: What is Telecare?

• Definitions of Telecare and Telehealth 4
• Benefits of Telecare 4

Section Three: Strategic Drivers

• National context 6
• National Performance Measures and Targets 7
• Local Context 8

Section Four: Service Aims, Objectives and Outcomes 8

Section Five: Service Development Process

• Strategic Planning Framework 9
• Project Management 9
• Ethics 10

Section Six: Service Components

• Operational Management 11
• Eligibility 11
• Assessment 12
• Procurement of Equipment 12
• Stock Control 13
• Equipment Installation, maintenance and recycling 13
• Monitoring Service (Call Centre) 13
• Response Service 14
• Charging 15
• Extra Care Housing 16
• Communication Strategy 16
• Workforce Training 17
• Review and Evaluation 17

Section Seven: Service Implementation

• Operational Development Plan 17

2
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011

Section One: Introduction

1.1. Vision for Telecare in Bridgend

The Telecare Project Board has agreed, in consultation, that the Telecare
service in Bridgend County Borough Council will be called Bridgelink. Our
vision for Bridgelink is that:

A person is able to access and use Telecare as the part of a care plan or a
preventative measure which enables them to continue to live in and perform
daily tasks within their home irrespective of the limitations imposed by their
frailty or disability.

1.2. Purpose of the Strategy

This Strategy aims to ensure a coordinated, consistent and integrated

approach to the development, funding and delivery of Telecare and
Telehealth Services across Bridgend County Borough over the period 2008 –
2011 and beyond. It will focus initially upon implementing Telecare but will do
so in way that will also provide a sound basis for the introduction of
Telehealth.

1.3. Telecare Capital and Revenue Grants

In 2006, the Minister for Health and Social Care announced that Telecare
Capital Grants would be allocated to Local Authorities with the aim of
supporting an extra 10,000 people in Wales with Telecare equipment. The
capital is to be spent on the purchase of equipment, and any costs directly
attributable to bringing it into working condition for its intended use, such as
installation costs. Subsequently, a Telecare Revenue Grant has been made
available to support the development and operation of telecare and/or
telehealth service delivery over the period of the Telecare Capital Grant.

1.4 Desired Outcomes from the Grant Funding

In total £8.92 Telecare Capital Grant has been allocated throughout Wales.
Bridgend received an allocation of funding from this Grant of £376,000 to be
spent by March 31st 2009, with a target of 500 new Telecare users by the end
of the grant period. Whilst the Welsh Assembly government have stated a
specific target for new users, it is clear that the Grant is designed to alter
outcomes for people and assist the modernisation of services. The Grant
must therefore be used to provide new services to new people and to add
value to existing services.

3
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011

Section Two : What is Telecare?

o Definitions of Telecare and Telehealth

Telecare and telehealth are different types are of Assistive Technology that
seek to support an individual’s dignity and independence.

2.1.Telecare is defined by the Welsh Assembly government, for grant

purposes, as a means by which care and support can be provided to people
with or without other services, through telecommunication and technologies in
the home. Equipment is designed to support the individual in their home and
to be tailored to meet their needs. Telecare typically employs sensors and
automated devices that enable the well–being of an individual to be monitored
remotely and contributes to people’s health, mobility, well-being and security.

2.2.Telehealth equipment is designed to complement health care. Telehealth

devices work by monitoring vital signs, such as blood pressure, and
transmitting the data to a response centre or clinician’s computer, where it is
monitored against parameters set by the individual’s clinician. Evidence that
vital signs are outside of ‘normal’ parameters triggers a response. To be
successful, Telehealth needs to be part of the local health and social care
pathway for managing long term conditions.

2.3. Used effectively Telecare and Telehealth can support the independence
and well being of older and disabled people. The technology enables carers to
respond more quickly to a crisis and can help prevent problems arising in the
first place by providing early indications of deterioration in an individual’s
health or well being. Telecare offers help when needed, and privacy at other
times.

o Benefits of Telecare

2.4. The outcomes expected from Telecare include:

• For service users, an increase in confidence in maintaining their
independence as a result of increased security or reassurance that
there is support available if needed;
• For carers, the confidence and re-assurance that there can be rapid
contact if there is a problem.

2.5. Telecare supports the overall strategic direction of social care and
housing policy. It provides an additional service choice to the increasing
numbers of older people and people with disabilities who wish to remain in
their own home and their carers. Telecare provides a platform for the
operation of existing community based services and supports the re-modelling
of existing services to meet the demands placed on social care service
delivery. Cost comparison exercises are beginning to demonstrate that

4
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
Telecare services can be good value for money, with savings derived from a
reduction of time spend in residential care, nursing homes and hospitals.

2.6. The people who can benefit the most from Telecare technology and
therefore who form the target groups for this Strategy are:

Potential service users Benefit

Older people, people with disabilities Supports users in their own homes
receiving care packages through care packages, as part of
general and supported housing services.
Provides confidence and reassurance
that there care be rapid contact if there is
a problem
People with a history of falls/at risk of Increased confidence to live at home .
falling Rapid response to fall decreasing
likelihood of hypothermia, fear and
complications.
Supports development of falls prevention
services
People with mild dementia Improves service user and carer
confidence, decreasing level of risk
associated with cognitive impairment
People with epilepsy Increased confidence to live at home for
service user and carers
People with long term conditions, for Enhanced Lifeline Alarms and Telecare
example, COPD, heart failure, angina services providing the basis for the
etc. monitoring of vital signs using telehealth
equipment.
People receiving Intermediate Care Supports the rehabilitation process by
packages increasing confidence to live at home,
especially following hospital discharge.
People with feeling anxious about Increased confidence to live at home
managing home safety risks, including a Provides confidence and reassurance
fear of violence intrusion or bogus callers that there care be rapid contact if there is
a problem

2.7. Telecare can not only benefit the user, but it can also provide
reassurance and practical assistance to carers, families and associated
organisations.

Wider Impact Benefit

Carers Can be contacted via the monitoring
centre or directly e.g. through a mobile
phone to warn them of a problem in a
family member/friends home
Support carers, via a carers emergency
card and the mobile response service, to
enable them to lead less restricted lives
Parents and family Confidence and reassurance that there
can be rapid contact if there is a problem

5
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
Housing Associations Can provide rapid response cover to
support users in sheltered housing rather
than admission to care home
Social services Supports users in their own homes as
part of a care package
Contributes to ‘step up’ facilities such as
intermediate care to prevent a move to a
care home
NHS Trust Contributes to ‘step up' facilities such as
intermediate care to prevent admission to
hospital.
Supports effective hospital discharge
Primary Care Effective part of a case management
system to prevent a move into a care
home or admission into hospital
Voluntary Organisations Support to users and carers directly
funded through statutory agencies

Section Three: Strategic Drivers

o National Context

3.1. Telecare addresses a number of different policy agendas dating back at

least a decade. Some to these relate to helping vulnerable people live
independently and safely at home, others to the reform of the health service
delivery. More recent policy documents have specifically focussed upon
Telecare.

The introduction of a Telecare service supports the Assembly Government’s

strategic direction for Health and Social Services throughout Wales. The
Review of Health and Social Care advised by Derek Wanless emphasised
the importance of prevention and earlier intervention across health and social
care.

The opportunities arising from the wider development of telecare services, to

maximise independence and support more domiciliary (rather than residential)
care features prominently in the Social Services Direction Paper A Strategy
for Social Services in Wales over the next decade: Fulfilled Lives,
Supportive Communities. It advocates that telecare is seen as a new
platform of service and stresses the importance of addressing systematically
the currently fragmented and inconsistent pattern of Telecare service
development across Wales.

Designed for Life also identifies the need for improvements in Telecare and
as part of its plans to re-design health services in Wales it acknowledges that
‘greater use of technologyB will reduce the need for hospital visits or
residential careB. The results of these developments will give individuals
greater control over their own quality of life’.

6
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
The Strategy for Older People in Wales and the NSF for Older People in
Wales promotes independence for older people and supports the aim to shift
service provision towards the community, enabling people to remain within
their own homes for longer. The NSF promotes the effective use of available
technologies to support this aim. Telecare is beneficial, in particular, in
managing the health of older people with long term and chronic conditions
and those with dementia within their own homes.

o National Performance Measures and Targets

3.2. A specific new Social Care target for Telecare has been introduced. The
implementation of Telecare will also potentially affect Bridgend’s performance
in relation to the other targets that are listed:

National Core Set Indicators (Adult Social Care)

SCA/010
The rate per 1000 people assessed during the year who are provided
with Assistive Technology as part of a package of care.
SCA/002
The rate of older people (aged 65 or over) : Helped to live at home per 1000
population aged 65 or over
SCA/003
The percentage of clients who are supported in the community during the year
who are: a) aged18-64 b) aged 65+
SCA/001 (NS1)
The rate of delayed transfers of care for social care reasons per 1000
population aged 75 and over
SCA/011
The percentage of delayed transfers of care due to: a) healthcare reasons b)
Social Care reasons c) Other reasons

SAFF Indicators (Health )

16
To reduce the number of delayed transfers of care in mental health facilities
per 10000 population
17
To reduce the number of days delayed for delayed transfers of care in mental
health facilities per 10000 population
18
To deliver through the development of Integrated Chronic Disease
Management system:
10% reduction in emergency admissions against the 2004/05 baseline
10% reduction in the number of bed days resulting in emergency admissions
against the 2004/05 baseline.
19

7
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
To reduce the numbers of delayed transfers of care (excluding mental health)
per 10000 population
20
To reduce the number of days delayed for delayed transfers of care
(excluding mental health ) per 10000 population

o Local Context
3.3. The overarching Strategic Objective of the Telecare Strategy is to support
the vision and values of the Bridgend County Borough Health, Social Care
and Well being Strategy that:

• The health and well-being of the people of the County Borough of

Bridgend will be among the best in Wales
• Everyone has appropriate access to first class services delivered by
organisations working together.

Also that the strategic development of Telecare and Telehealth in the County
Borough will also be key to the ‘Delivering Integrated Services’ partnership
project across the health and social care community within the area of the
Abertawe Morgannwg University NHS Trust

3.4. The development of Telecare in Bridgend is occurring at a time of

considerable change within existing adult social care services. A priority within
this remodelling is to ensure that Telecare services are developed as a core
element of mainstream services and their continuing sustainability is ensured.

Section Four: Service Aims, Objectives and Outcomes

4.1. The aim of developing a Telecare service is to contribute to a coherent

and integrated range of services that are person centred and are designed to
assist and maintain people in their own home with an increased sense of
safety, security and confidence.

4.2 The objectives of the service are to:

• Offer people a flexible and non-institutional tool to help them maintain

independence, maintain confidence, have greater control and choice
as a result of increased security or reassurance that there is support
available if needed
• Create potential for keeping people at home for longer before needing
a residential care placement and for helping people to return home
from hospital with greater confidence

8
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
o Enable an increasing numbers of older people and people with
disabilities with more complex needs to remain in their own home
without growing numbers of carers
• Assist in the development of an integrated and streamlined approach to
service delivery, that avoids duplication of effort and resources, and
provides value for money
• Provide carers with confidence and re-assurance that there can be
rapid contact if there is a problem and thus increase their ability to fulfil
their caring role.
• Ensure a strong service process including appropriately sourcing,
procuring, storing, delivering, installing, collecting, recycling,
maintaining and testing of equipment

4.3 Telecare and Telehealth services offer the potential to:

• Provide reassurance and support the confidence of service users and
their carers
• Give users greater control of their own lives by reminding them of tasks
that they wish to compete or providing information about developing
risks.
• Identify changes in the personal circumstances of the user and enable
an immediate and appropriate response.
• Support professionals in making risk and care assessments
• Enable care professionals to shorten the time period between the
occurrence of an event and the delivery of the appropriate care
interventions
• Provide effective support for carers alongside traditional healthcare,
social care and housing initiatives.

Section Five: Service Development Process

o Strategic Planning Framework

5.1 The overall responsibility for the development of Telecare in Bridgend

County Borough rests with the Health and Social Care Partnership Board.
Progress on the development and review of the Telecare Strategy will be
reported from the Bridgend Telecare Project Board via the Joint Executive
Team to this Board.

o Project Management

5.2 The Bridgend County Borough Telecare Project Board was established in
September 2006 is a multi agency group to oversee the development and
implementation of this Strategy. The Board’s Terms of Reference proposed a
structure that ensures, when necessary, task and finish groups will be formed
to identify the detail of Telecare service components and ensure that they
complement core services.

5.3. The Telecare Project Board has agreed the following principles as a basis
for implementing the Telecare service.

9
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011

• Exploring options for further developing joint commissioning and

working arrangements with other statutory agencies and other
providers.
• Viewing a range of multi agency approaches adopted for
commissioning services with the aim of formalising specific
arrangements with Bridgend County Borough Local Health Board using
Health Act 1999 flexibilities
• Strengthening partnership arrangements with the independent and
voluntary providers in accordance with the Bridgend Compact
agreement with the voluntary sector and ‘Promoting Partnership in
Care: Commissioning social care and health services’
• Exploring in partnership with the LHB, NHS Trust and Local Authority
community case managers working with people with long-term
conditions the benefits of extending the use of Telehealth technology
where appropriate
• Evolving further our notion of regional commissioning in line with
‘Making the Connections’ by forming regional partnerships for jointly
commissioning social care and housing services with other local
partners.
• Working closely across services to ensure that the development of an
integrated community equipment service between the Abertawe
Morgannwg University NHS Trust, Bridgend Local Health Board and
Bridgend County Borough Council in partnership with neighbouring
authorities enables the effective implementation of the Telecare
service.

5.4. A Telecare Project Manager has been appointed on a fixed term contract
to lead the initial stages of the implementation process.

o Ethics

5.5. The introduction of the Telecare service raises ethical concerns. The
service will initially use technology which is more sophisticated than the
simple community alarm but not so advanced and intuitive as the computer-
based high-technology systems. An ethical framework for the service will form
part of the operational procedures and will be informed by the existing policies
of the partner organisations.

This framework needs to be applicable for all levels of technology and to

cover issues such as the capacity to give informed consent, the minimising of
intrusion, respect for individual privacy. There needs to be constant vigilance
with regard to the rapidly changing technology available to ensure that the
ethical issues posed are debated and resolved as the service develops.

10
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011

Section Six: Service Components

o Operational Management

6.1 It is envisaged that as the service becomes operational, a Telecare Co-

ordinator will be required. The Coordinator will provide day to day operational
co-ordination of the new Telecare service and will continue to develop
systems and procedures to ensure that Telecare becomes an integral part of
managing prevention and maximising independence within Bridgend.

The Co-ordinator will act as a link between professional staff, contractors,

call centres, response services, users and carers. The Co-ordinator will
handle referrals, assessments and reviews for the Telecare service, offering
advice and assistance to ensure that the appropriate Telecare products are
identified, installed, maintained and recycled.

The Co-ordinator will also safeguard the performance of the Telecare

service, overseeing the development and management of a robust
performance monitoring process to ensure continuous service
improvement.

o Eligibility

6.2 ` The service will be entirely needs based. Telecare will be available to
people living in any part of Bridgend. There are no restrictions on the age of
the person who may benefit from the provision of telecare or any criteria
linked to the tenure of the person’s home.

6.3. The following outcomes will be considered as indicators of a person

needing a Telecare service:

• Reduction in risks associated with falls

• Reduction in anxiety/improved well being of informal carers
• Preventing future hospital admissions
• Prevention of placement into a care home
• Reduction in the provision of care
• Reduction of risks of mental health or learning disabilities
• To support wellbeing/independence upon hospital discharge
• Reduction in anxiety due to social isolation
• Reduction in anxiety resulting from crime or fear of crime

6.4 The priority target group of people for this Strategy will be those older and
disabled people who, following a unified assessment, have been determined
as eligible for services to support them to live in their own home. Telecare
services will contribute to their care plan as an integral part of the other social
care services provided or as a preventative measure to delay the need for
other services. It will therefore be aimed at potential/new and existing users of
the Council’s Social Care services.

11
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011

6.5 The needs of their carers will also be taken into account when assessing
for a Telecare service and a carers’ emergency card linked directly to the
monitoring centre will be developed to provide additional reassurance if they
are delayed or incapacitated whilst away from the cared for person.

6.6 The criteria will include people who live in residential care homes and
other supported living environments in the community and the use of Telecare
equipment will assist in providing help when needed and privacy at other
times.

6.7 Following more detailed costing, it may be possible to identify a further

group of people who are demonstrated to benefit from a preventative Telecare
service and who may be offered Telecare equipment and installation.

6.8. All other Bridgend residents will be advised about entering into private
arrangements with the Monitoring Centre used by the Council or another of
their choice but will meet the full cost of the service outside the current grant
arrangements.

o Assessment

6.9. Telecare service will become one means to meet the needs of those who
are assessed as requiring help to remain in their own home, following a
unified assessment under the NHS and Community Care Act.

6.10. It is envisaged that the specialist assessment for Telecare will initially be
part of a holistic Occupational Therapy Assessment. As the equipment
becomes more familiar then it is anticipated that social workers and care
managers will be able to prescribe standard home safety packages. The
Occupational Therapists will retain responsibility for the assessment of more
complex packages.

6.11 In the initial grant period, the Community Occupational Therapists will
also work closely with Bridgend County Care and Repair in order to expedite
the assessment of standard Telecare packages to increase home safety. The
Care and Repair Agency will offer risk assessments to those people who
already have community alarms and fit Home Safety and Home Security
packages where appropriate in the initial grant period.

6.12. Occupational Therapists employed by Aber Bro Morgannwg University

NHS Trust will also be able to undertake specialist assessments for Telecare
in order to expedite hospital discharge.

o Equipment: Procurement

6.13 The Welsh Assembly Government have confirmed that all the suppliers,
products and services on the NHS Purchasing and Supply Agency (NHS
PASA) National Framework Agreement for Telecare (NFA) for Telecare have
been competitively market tested via an OJEU/EU Public Procurement

12
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
tendering exercise. They are satisfied that Local Authorities using the
agreement are therefore not required to undertake their own tendering
exercises.

6.14. Purchasing through the NHS PASA framework has enabled the Council
to make savings on Telecare equipment costs. There is the potential during
the period covered by this Strategy to obtain further price discounts by making
volume purchases via a regional or national procurement forum.

o Equipment: Stock Control

6.15 Telecare equipment is in itself not different from any other equipment
supplied to assist people with activities of daily living, except for the different
maintenance requirements of the various items. It is the intention that in the
medium term that Telecare equipment will be managed within the Integrated
Community Equipment Service (ICES) and all stock control, storage, delivery,
and recycling will be included in this contract.

6.16. In the short term, Vision Products in Pontyclun who currently supply the
County Borough with other equipment have entered into an agreement with
the Council to provide this facility.

o Equipment: Installation, Maintenance and Recycling

6.17 It is essential that Telecare equipment is installed, maintained and

removed by trained staff. The Council has therefore extended its current
contractual arrangements with Bridgend County Care and Repair Agency to
act as trusted assessors to offer risk assessments and provide this service in
respect of Telecare equipment.

o Monitoring Service (Call Centre)

6.18 The monitoring centre is the key to a successful Telecare service both in
terms of response to users on a day to day basis and also as a route to
emergency and other services. The County Borough does not currently have
a monitoring centre, and this provides the opportunity in the period covered by
this Strategy to consider how this aspect of the service may best be provided.

6.19 Currently, Merthyr County Borough Council monitors approximately 1100

Community Alarm users from Bridgend, many of whom are existing users of
social care services. The County Borough is developing a Service Level
Agreement with Merthyr County Borough Council in respect of the provision of
Telecare packages. The Wales and West Housing Association Monitoring
Centre in Cardiff also monitors approximately 650 residents of Bridgend who
are their tenants or those of Valleys2Coast out of hours. This arrangement will

13
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
continue if any tenant has telecare installed. Other people within the County
Borough will have community alarms that are monitored by other monitoring
centres such as Age Concern.

6.20 As soon as the Response Service is fully operational, a carers’

emergency card will be introduced. The Merthyr County Borough Council
monitoring centre will be required to provide support to carers who carry a
carers’ emergency card in an emergency. Carers will be able to contact the
Monitoring Centre directly and ask for support for the cared for person if they
are unable to perform their caring role as a result of an unforeseen event
arising whilst they are away from home.

o Response Service

6.21 One of the benefits of the implementation of Telecare services is the

ability to respond to real time needs and emergencies notified both via the
community alarms and through the Telecare sensors. Many such alarms
require a social care rather than an emergency service. Consequently, it is
necessary to develop a service that can be called upon at any time, 24 hours
a day. The planned service will deal with lower level emergencies, working in
partnership with GPs and also the emergency services, especially the
ambulance service.

6.22 The need for such a service is evidenced by the fact that that the number
of people who have private contracts with the Monitoring Centres are limited
by the requirement to provide two key holders. Others provide details of
neighbours who by virtue of their own frailty are unable to offer an effective
response. In consequent, many of the most isolated are unable to receive a
service for which their need may be greatest. Consultation with older people
has confirmed this to be the case, and also given indications that this is a
service that people would welcome to provide reassurance whilst maintaining
independence and dignity.

6.23 A ‘Task and Finish’ Group was established by the Project Board to
develop an emergency response service model and to ensure its integration
with other services. The group includes representatives of users and carers,
the Ambulance Trust and the Fire Service. From the outset, this group has
been committed to ensuring that the proposed service will have close links to
the emergency services, current community health and social care services,
such as the Home Care and the District Nursing services, and also to
Intermediate Care services.

6.24 In Bridgend, there has been a long standing recognition of the need to
develop a comprehensive range of rapid response services as part the
agenda to develop integrated services that promote independence.

Such a service was established on a small scale in 2001, and there is now
one Rapid Response Officer available during office hours on weekdays and
mornings only at the weekends. This has had a beneficial effect upon the
number of Delayed Transfers of Care in the County Borough. The need to

14
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
expand of this service, both in terms of the number of staff available, and the
number of hours a day that the service operates, has been acknowledged for
some time.

6.25 The full implementation of Telecare will take some years as public
awareness about the potential value of the service develops. The need for a
response service to support Telecare is however immediate. The Task and
Finish Group decided that to combine the proposed mobile response service
with the existing rapid response service would be beneficial. This would
ensure the maximum flexibility of response at all times provided by staff that
are able to provide personal care. It would also ensure that the staff working
in the service would be fully employed from 8.00 am to 8.00 pm, with a large
enough staff team to operate a viable rota which would include two staff being
on call from home overnight. The staff will be supervised by a Team Leader
who will be responsible to ensuring that they are effectively deployed and
ensuring that activations of sensors are monitored and appropriate action
taken.

6.26 The Telecare Project Board has approved a model for the BridgeLink
Response service that incorporates the present home care rapid response
service and the mobile response service required to support Telecare. The
service will be provided 24 hours a day, seven days a week.

6.27 The Telecare Project Board has also approved the proposal that any
person accessing Telecare as part of an assessed package would be required
to include the BridgeLink response service as one of their responders in order
to mitigate the risks associated with installing Telecare equipment without the
appropriate range of responses in place.

6.28 It is anticipated that performance information from the BridgeLink

response service will drive other changes in service delivery such as the
provision of more flexible home care, emergency night sitters and new
services such as falls prevention services.

o Charging

6.29 The Welsh Assembly government is quite explicit that there can be no
charge for equipment purchased, supplied and installed through the Telecare
Capital Funding Grant. A charge can however be made for revenue services
associated with Telecare, in particular, the monitoring and response services.

6.30 The current average cost of the proposed Telecare packages is £700,
within a range from £390 to £1200 and, depending upon type, the equipment
needs replacing after one to five years. In order to ensure that the service is
sustainable, provision needs to be made to cover this expenditure. It is
anticipated that demonstrable savings by delaying the need to access home
care and residential care will offset some of this cost.

6.31 Initially the Telecare service will be targeted on those people for whom
Telecare is provided as part of an assessed care plan, enabling people to stay

15
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011
at home. The costs will therefore be charged within the Council’s Fairer
Charging and Fairer Access to Care services (FACS) policy. This policy
currently includes a 40% disregard on the cost of services which is applied
when calculating how much an individual will pay for services provided to
them.

6.32 It is proposed that a single charge is made for the Telecare service to
include the call centre monitoring, the maintenance of the equipment, and the
mobile response service for those people who will access Telecare as part of
any assessed package of care. A current charge of £5.26 per week is
proposed, to be reviewed in line with charges for other non residential
services.

6.33 A phased approach to the implementation of Telecare is planned. It is

recognised that it will be possible to identify other groups of people who could
benefit from a preventative Telecare service who will fall outside the Council’s
Fairer Charging and Fairer Access to Care services (FACS) policy. The
additional costs of offering a service to further groups of people will depend in
part to the take up of the service by those with assessed care packages.
Further work will be required to assess whether it will be possible to offer a
service to these groups of people whilst ensuring the sustainability of the
service.

6.34 Other people will continue to purchase a community alarm service from
whatever provider they choose in order to provide reassurance. It can be
argued that to promote independence at home and encourage the growing
use of Telecare in the future, and that these people should also be able to
purchase the mobile response service that will be offered by the Council. This
will also be reviewed as the implementation of Telecare proceeds.

6.35 In all cases, the community alarm system is provided via a landline
telephone rental which will be the responsibility of the user.

o Extra Care/Supported Housing

6.36 It is anticipated that Telecare equipment will play a significant role in the
service provided by designated extra care and supported housing
accommodation, reducing the level of personal intrusion whilst monitoring,
and alerting staff to emergencies and health changes in a timelier manner.

6.37 Where such equipment is not currently available it must be considered in

and the upgrading of present accommodation and included in the
specifications for new build accommodation.

o Communication Strategy

6.38 It is essential that opportunities continue to be sought to communicate

the benefits of Telecare to the general public. This will be undertaken using all
the various mediums of communication now available in partnership with all
the organisations involved in the development process.

16
 BridgeLink: Assuring Independence at home
Telecare Strategy for Bridgend 2008 – 2011

o Workforce Training

6.39 The implementation of Telecare will impact in a number of ways upon the
delivery of other services. There is therefore a significant awareness raising
and training implication for staff who will need to understand the options and
benefits of Telecare. This will assist them when assessing need, in care
planning and in explaining Telecare to users and carers. Also, for home based
staff training will be required on the role of Telecare and how to use Telecare
equipment.

6.40 Training programmes will continue to be delivered to support the

implementation of the Strategy. This process will be enabled by the SMART
flat at Cwrt Gwalia, Ogmore Vale, which has kindly been provided by Linc
Cymru to facilitate the training of staff and the demonstration of equipment to
potential service users.

o Review and Evaluation

6.41 For the period of the Telecare Grant Funding, the Welsh Assembly
government will require the implementation of Telecare to be reviewed at
annual intervals. It is proposed that the implementation is also subject to an
annual review that includes an assessment of its effectiveness and its
continued sustainability.

6.42 Whilst the Welsh Assembly Government has identified and output target
of 10000 new users of Telecare in Wales by the end of the Grant period, there
is also a need to demonstrate the impact upon the modernisation of social
care services and on acute care services. An evaluation plan will therefore be
developed as part of the implementation of Telecare. This will report against
local Performance Objectives for the Telecare service and seek to
demonstrate the effects upon the whole system.

Section Seven: Service Implementation

7.1. The Telecare Grants must be spent by 31st March 2009. it is imperative
therefore that each of the elements of the Telecare service is operational and
by the Autumn 2008.

7.2 The Telecare Project Board will be responsible for developing a

detailed service implementation plan to ensure the development of
sustainable effective Telecare services that will also support the integrated
development of Telehealth service.

17